Indian Journal of Radiology and Imaging Indian Journal of Radiology and Imaging

MUSCULOSKELETAL
Year
: 2004  |  Volume : 14  |  Issue : 2  |  Page : 177--178

Intra-muscular myxoma of gluteal region


RA Aind, MK Dwivedi, R Pal, L Devangan, PV Shekhar 
 Department of Radiodiagnosis, Jawaharlal Nehru Hospital and Research Centre, Sector-9, Bhilai, (Chattisgarh) Pin-490009, India

Correspondence Address:
R A Aind
Department of Radiodiagnosis, Jawaharlal Nehru Hospital and Research Centre, Sector-9, Bhilai, (Chattisgarh) Pin-490009
India




How to cite this article:
Aind R A, Dwivedi M K, Pal R, Devangan L, Shekhar P V. Intra-muscular myxoma of gluteal region.Indian J Radiol Imaging 2004;14:177-178


How to cite this URL:
Aind R A, Dwivedi M K, Pal R, Devangan L, Shekhar P V. Intra-muscular myxoma of gluteal region. Indian J Radiol Imaging [serial online] 2004 [cited 2019 Aug 22 ];14:177-178
Available from: http://www.ijri.org/text.asp?2004/14/2/177/28580


Full Text

 Introduction



Myxoma is a true mesenchymal neoplasm, composed of undifferentiated spindle and stellate shaped cells in a background of myxoid stroma [1]. It originates from primitive mesenchymal cells that differentiate into altered fibroblast [1].

Well-defined ovoid mass surrounded by normal muscle which was hypoechoic with small fluid filed cleft cystic space with distal acoustic shadow

 Case Report



Thirty-three years old woman presented with a h/o painless hard mass in the left gluteal region, which was noticed, accidentally of short duration. No h/o trauma.

X-ray AP. Left lateral oblique and tangential view of the pelvis were normal.

US examination of the left gluteal region using 7.5MHz linear array electronic transducer (SONOLINE PRIMA) was performed. The sonographic examination revealed well defined ovoid mass surrounded by normal muscle which was hypo-echoic with small fluid filled cleft cystic space with distal acoustic shadow [Figure 1]

Well-defined ovoid shaped homogenous mass with density lower than muscle occupying the gluteal muscle CT revealed well-defined ovoid shaped homogeneous mass with density lower than muscle occupying the gluteus maximus muscle [Figure 2]. No enhancement of the lesion is seen in CECT.

F.A.N.C. showed abundant myxoid material in the background with slender tumor cells with elongated cytoplasmic process. Few histocytes like cells also seen suggestive of intra-muscular myxoma.

 Discussion



In 1871 Virehow used the term myxoma to describe a tumor that histologically resembled the mucinous substance of the umbilical cord [1]. Myxoma are uncommon benign neoplasm [1],[3],[4],[5]. Intramuscular myxoma frequently occurs in middle age between 40-70 yrs [1],[3],[4],[5]. Most intra muscular myxoma are solitary, painless palpable mass that is firm in slightly movable often fluctuant [4]. Slightly more common in women than men [1],[4]. Most frequent site of the tumor are - large muscle of the thigh, shoulder, buttocks, upper arm [3],[4]. A small subset of these tumors is associated with underlying Fibrous dysplasia frequently with polyostotic variety. This association was first described in 1920 and was given its current name by Mazarbraud and associate in 1967 as Mazabraud syndrome [5]. CT has been widely used for detection and staging of soft tissue tumor [3]. MRI can accurately detect and stage soft tissue masses and is more sensitive for lesion than CT [3]. On MRI-T1W1-Low signal intensity, T2W1 - High signal intensity [1],[3],[5]. It is difficult to diagnose the tumor before biopsy and microscopic examination [4]. It has no tendency towards recurrence and is cured by local excision and is easily mistaken for a sarcoma especially myxoid liposarcoma and botryoid type rhabdomyosarcoma. [4]. Angiographic examination reveals a poorly vascularised soft tissue mass surrounded by well vascularised 'muscle tissue [4]. Despite their frequent large size and prominent myxoid appearance, intramuscular myxomas are benign and very rarely recur locally [4][6].

References

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2B.D. Fornage And M.M. Romsdahl. Intra Muscular Myxoma. Sonographic Appearance And Sonographically Guided Needle Biopsy, Jum Voll 3, Issue 2 91-94.
3John. R. Hagga. Charles. F. Lanzier, David J Sartoris, Elias A. Zerhovni Vol 2, Musculoskeletal Tumor: 1420.
4Franz M. Enzinger, Sharon. W. Weiss, Eight Edition Benign Soft Tissue Tumor Of Uncertain Type 1045-1051.
5Musculoskeletal Case 8 Diagnosis Cjs - February - 2000 43: 62-3. Mazabrau'd Syndrome- Intra-Muscular Myxoma Associated With Fibrous Dysphasia
6Mirela Stancu, M.D. And Kar - Ming Fung M.D. Phd Pub Med July 2003 Case 307-2